Home > Behavior, Head injury, Medical issues, Stages of dementia, Types of dementia > Stages of Chronic Traumatic Encephalopathy

Stages of Chronic Traumatic Encephalopathy

I have written several times here on the subject of Chronic Traumatic Encephalopathy (CTE), which is the particular form of dementia found in some athletes and others who are subjected to concussions and head injuries.  There are a couple of reasons that I’ve become interested in this subject; one is because CTE is entirely preventable, and the other is because so many of our young people are being placed at risk due to their participation in athletics and similar activities.  Now, researchers at the Boston University Center for Chronic Traumatic Encephalopathy have delineated what they say are four distinct behavioral phases of the disorder.

In this study, autopsies were performed on the brains of 85 people, 68 of which showed “tangles” of the protein tau that are unique to those with CTE, as opposed to the types of structures found in Alzheimer’s disease or frontotemporal dementia.  50 of these individuals had been football players — 33 of them having played with the NFL.  The others who participated in the study were high school or college football players, hockey players, and one wrestler.  One had a history of “self-injurious head-banging behavior.”

By examining these brains, researchers were able to rate them as having stage I, II, III, or IV CTE.  Then, by interviewing the families of the deceased study participants, they were able to identify behaviors and emotions which corresponded to each stage of the disease.  Here is a short summary of what they found:

Stage I:  The person will experience headaches and problems paying attention.  There may also be short-term memory loss, depression, and tendencies toward aggression.  Some problems with executive function and explosivity were also recorded.

Stage II:  Those at this stage were more prone to headaches and problems with attention and concentration, as well as mood swings, short-term memory loss, and impulsivity.  More infrequently, there may also have been a tendency toward suicidal thoughts and language problems.

Stage III:  Along with the previously-noted symptoms, these persons were also plagued by visuospatial difficulties, more pronounced cognitive and memory problems, and apathy.  Researchers reported that 75% of individuals at this level were perceived as having cognitive problems.

Stage IV:  At this stage, individuals exhibited more significant problems with cognition and memory.  They also often showed profound difficulties with attention and concentration, executive dysfunction, explosivity, tendencies toward aggression, depression, paranoia, and gait and visuospatial difficulties.  30% of those at this level were suicidal to some extent, and some experienced parkinson-like behaviors.

Of those persons who were included in the study, 37% were noted to have been diagnosed with another neurodegenerative disease (including Alzheimer’s, frontotemporal dementia, Lewy Body disease, or Parkinsonism).  This suggests that as CTE develops, it may trigger other disease processes.  However, it is also significant to note that 11% of those who were found to have CTE did not show any of the afore-mentioned symptoms.  It was also noted that the severity of the CTE may be connected to how the individuals played football, suggesting that it occurs more often as a result of frequent mild injuries rather than one or two more severe ones.

You can read more about the study here.


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